One‐stage, simultaneous skin grafting with artificial dermis and basic fibroblast growth factor successfully improves elasticity with maturation of scar formation

Abstract

The efficacy of one‐stage artificial dermis and skin grafting was tested in a nude rat model. Reconstruction with artificial dermis is usually a two‐stage procedure with 2‐ to 3‐week intermission. If one‐stage use of artificial dermis and split‐thickness skin grafting are effective, the overall burden on patients and the medical cost will markedly decrease. The graft take rate, contraction rate, tissue elasticity, histology, morphometric analysis of the dermal thickness, fibroblast counting, immunohistochemistry of α‐smooth muscle actin, matrix metalloproteinase‐2, CD31, and F4/80, as well as gelatin zymography, real‐time reverse transcriptase polymerase chain reaction for matrix metalloproteinase‐2, and electron microscopy, were investigated from day 3 to 3 months postoperatively. The graft take rate was good overall in one‐stage artificial dermis and skin grafting groups up to 3 weeks, and the contraction rate was greater in the two‐staged artificial dermis and skin grafting group than in the skin grafting alone or one stage of artificial dermis and skin grafting groups. Split‐thickness skin grafting with artificial dermis and basic fibroblast growth factor at a concentration of 1 μg/cm2 showed significantly greater elasticity by Cutometer, and the dermal thickness was significantly thinner, fibroblast counting was significantly greater, and the α‐smooth muscle actin expression level was more notable with a more mature blood supply in the dermis and more organized dermal fibrils by electron microscopy at 3 weeks. Thus, one‐stage artificial dermis and split‐thickness skin grafting with basic fibroblast growth factor show a high graft take rate and better tissue elasticity determined by Cutometer analysis, maturity of the dermis, and increased fibroblast number and blood supply compared to a standard two‐stage reconstruction.

Retrospective analysis of 56 soft tissue defects treated with one‐stage reconstruction using dermal skin substitutes

“…In Figure , we present a decision tree for the use of this method. Recent studies also suggest that the addition of basic fibroblast growth factor may result in improved tissue elasticity and scar maturation .…”

Weight‐bearing–induced changes in the microtopography and structural stiffness of human skin in vivo following immobility periods

“…Skin deformability was measured with the Cutometer MPA 580 device and the corresponding software (Courage & Khazaka Electronic GmbH, Cologne, Germany), which is an established method in in vitro and human skin research. A pressure of −450 mBar and a probe opening of 2 mm diameter were used.…”

Pre-vascularization Enhances Therapeutic Effects of Human Mesenchymal Stem Cell Sheets in Full Thickness Skin Wound Repair

“…It was proposed that hMSCs participate in wound healing by functioning as: 1) trophic mediators to modulate T-cells, neutralize reactive oxygen species, and inhibit fibrosis; 2) progenitor cells transdifferentiating into multi-types of skin cells to promote tissue regeneration 7. Many hMSC related studies have been conducted in immune compromised rodents 57-59, in which multiple skin transplantation models have been tried 60. However, due to the importance of the immune system in wound healing 61, 62, an immune competent rat model was chosen in this study for the purpose of simulating healing processes in human wound repair 63.…”